Background: Ectopic pregnancy is an obstetric emergency with high morbidity and mortality. Incidence of ectopic pregnancies has been increasing in last two to three decades with reduction in mortality. The presenting symptoms include irregular vaginal bleeding. The present study was undertaken to study the clinical features of ectopic pregnancies in a tertiary care hospital.Methods: The present study on ectopic pregnancies was carried out in department of obstetrics and gynaecology, jhalawar medical college, Jhalawar, Rajasthan, India from January 2019 to October 2019. All patients admitted with diagnosis of ectopic pregnancy, either ruptured or unruptured where included in the study.Results: Total 52 patient of ectopic pregnancy were studies. Majority (63.46%) of patients belong to the age group 21-30 years. Ectopic pregnancy was most commonly noted in nulliparous woman (44.23%) Majority of the case (31%) had no risk factors among remaining (34.61%), previous MTP (17%), (17-30%) previous ectopic (9%) and PID (15-38%) were identified risk factors. Ampulla (75%) was the most common site for ectopic pregnancy. 57% of the cases were on the right side. The common presenting complaints were pain in abdomen (81%) bleeding/ spotting per vaginal (42%). There was no mortality.Conclusions: Surgical treatment was done more often because of patients reporting late to the hospital screening of high-risk case, early diagnosis and early intervention reduce the morbidity and mortality in ectopic pregnancies.
Background: Uterine rupture is a catastrophic obstetrical emergency associated with a significant fetomaternal morbidity and mortality. Many risk factors for uterine rupture, as well as a wide range of clinical presentations have been identified. The objectives of the present study were to analyze the frequency, predisposing factors, maternal and fetal outcomes of unscarred uterine rupture.Methods: A retrospective analysis of cases of unscarred uterine rupture was conducted at the Department of Obstetrics and Gynaecology Jhalawar medical college Jhalawar Rajasthan from January 2009 to December 2016.Results: Our analysis comprised of 11 cases with unscarred uterine rupture. Incidence of unscarred uterine rupture is 0.01% or 1/10,000 deliveries.Conclusions: In our study there was no history of uterine scarring so the main predisposing factor are maltiparity and obstructed labour. The grand multiparas women and obstructed labour must be managed by proper trained personnel and in tertiary care center in order to avoid the morbidity and mortality.
Background: Lactate Dehydrogenase (LDH) is mainly an intracellular enzyme. Its level is an useful biomarker for cellular injury which may suggested as a potential marker to predict the severity of preeclampsia and indicator for multi-organ involvement have significant role in management of preeclampsia. We conducted this study to examine the relationship between lactate dehydrogenase concentration and the severity of the disease and occurrence of complications. The objective of the present study was to assess role of serum LDH level in mild and severe preeclamptic women Methods: This prospective study was conducted in the Department of obstetrics and gynecology in Jhalawar medical college from Jan 2017 to Oct 2017 Total 120 pregnant women during third trimester (32-40 weeks) aged 18 to 35 years were selected. Among them 40 were severe preeclampsia and 40 were mild preeclampsia patients and 40 were healthy normotensive control. Serum LDH level was estimated by continuous spectrophotometric method. Demographic, hemodynamic, and laboratory data were compared among the three groups. The symptoms and complications of severe pre-eclampsia along with foetal outcome were analyzed according to the levels of LDH. Results: In this study, serum LDH level was significantly higher (P<0.001) in preeclamptic compared to those of control. Again, this value was significantly higher in severe preeclamptic than those of mild preeclamptic. The symptoms and complications of preeclampsia along with perinatal mortality were increased significantly in patents with LDH> 800IU/I compared with those who had lower levels. Conclusions: From this study, it can be concluded that elevated serum LDH level is associated with severity of preeclampsia. LDH has been evaluated as a biochemical marker for preeclampsia and as a prognosticator of the disease severity. Detection of high-risk patients with increased levels of LDH mandate close monitoring and management to prevent maternal and fetal morbidity and mortality.
PPH is almost entirely a preventable condition when management is based on scientifically proven methods. It occurs in approximately 4% of vaginal deliveries, and estimates are that it causes significant morbidity and 25% of all the maternal child birth related deaths. We conducted this study with the following aims to compare the effectiveness of rectal misoprostol (600mcg) with intravenous methylergometrine (0.2mg) and intramuscular PGF2α (125mcg). To find out the percentage of pregnant women having postpartum hemorrhage, amount of blood loss and efficacy and safety of uterotonic drugs during third stage of labor. Patients with full-term singleton pregnancy in the age group of 20-35 years admitted in the maternity ward for vaginal delivery were enrolled in the study after taking written informed consent. The third stage of labor was actively managed in these patients by either 600mcg of misoprostol per rectally (Group A) or 0.2mg of IV methylergometrine (Group B) or 125mcg of PGF2α intramuscularly (Group C) and some were given any prophylactic oxytocic (Group D). Majority 110 (55%) of the studies participants were in the age group of 20-24 years. Moreover, 109 (54.5%) belonged to upper middle (II) socioeconomic class as per modified Kuppuswamy’s socioeconomic scale update for 2018. Only, 7 (3.5%) of the participants were grand multipara’s while 24 (12%) had gestational age greater than 40 weeks. Mean maternal age, gestational age and duration of third stage of labor was comparable in all the study groups. Maximum amount of blood loss was seen among participants who were in control group (201.80 ± 122.81 ml) and the maximum ‘mean difference in Hb’ was also seen in control group (0.83 gm%). Reported side effects during the study included diarrhea, nausea, shivering and vomiting in (1.5%) participants. Postpartum hemorrhage and retained placenta was reported among 7 (3.5%) and 2 (1%) participants only.Misoprostol can be used as a safe and effective alternative agent in active management of third stage of labor.
Background: The aim of the study was to study the socio-demographic factors in cases of pregnancy induced hypertension and its associated risk factors in a tertiary care hospital.Methods: The present retrospective study was conducted in the obstetrics and gynecology department of Shrimati Heera Kunwar Baa Memorial Hospital, Jhalawar, Rajasthan from December 2018 to November 2019. A total of 80 cases of pregnant women with PIH were studied. The socio-demographic data like age, parity, gestational age of presentation, mode of delivery, maternal and perinatal complications were noted from the hospital records and studied.Results: The incidence of PIH was found to be 8.16% in pregnant women attending the SHKBM Hospital. Majority of the study subjects were rural dweller (70%). A higher incidence of PIH was found among illiterate women (51.25%). 53.75% cases were in the age group of 25-30 years and 25% were in the age group of 19-24 years. In the present study, incidence of PIH was found to be highest among primigravidas (67.50%) as compared to multigravidas (32.5%). Most cases were delivered by caesarean section (73.75%) and 26.25% were delivered vaginally. Out of 80 cases, 16.25% of cases were complicated by eclampsia, Severe PIH in 12.5%, abruptio placentae in 2.5% and HELLP Syndrome in 1.25% cases.Conclusions: PIH is a very common complication encountered in pregnancy associated with adverse maternal and fetal outcome. The risk is higher among young primigravidas and in rural population. Better health care facilities and awareness among the pregnant women will help in reducing the incidence of PIH and its associated complications.
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